Healthcare Provider Details

I. General information

NPI: 1538978093
Provider Name (Legal Business Name): CLAUDIA COKER PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 DALLAS HWY SW STE 202
MARIETTA GA
30064-7505
US

IV. Provider business mailing address

1414 BENBROOKE RDG NW
ACWORTH GA
30101-3547
US

V. Phone/Fax

Practice location:
  • Phone: 240-855-6887
  • Fax:
Mailing address:
  • Phone: 240-855-6887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-4044811
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: